Contact| Forum

Research Outputs

Work Package 3

Research Topic

Medication Errors in Primary Care

Lead: Paracelsus Medical University,
Austria.

Contact: Andreas Söennichsen

Description of work

Introduction

Why the research topic is important

Improving medication safety has become a major topic not only in clinical settings, but also in primary care. To prevent adverse drug events before they happen, interventions such as e.g. information technology (IT) or pharmacist-led interventions can play an important role to support health care professionals. By researching and networking nationally and internationally we can learn and build upon existing types of intervention to improve medication safety and in this way promote further research as well as spread the collected information.

What have we done (our approach)

We started our work by identifying the causes and collecting all the existing types of interventions on medication safety in primary care in Europe, which were presented in our first LINNEAUS meeting in October 2009 and will soon be available as a review. Thereafter we conducted our first systematic review on the “Prevalence of Adverse Drug Events in Ambulatory Care” to obtain an overview of the epidemiology and prevalence on this topic. Subsequently we conducted a second systematic review on the question “Information technology (IT) interventions to improve medication safety in primary care”. Additionally our results were presented at conferences in Austria, Manchester, Copenhagen, Warsaw, Lodz and Vienna. We have also created a network of General Practitioners and other health care professionals, who will be able to obtain tools for medication and patient safety issues in a platform through our webpage.

What is/are the key result(s) and why are the results important?

To summarize from our reviews, we can say that there was and still is a great need in researching and defining medication safety and errors in primary care. Within the LINNEAUS-Euro PC project we have contributed with a compilation of papers as well as a preliminary taxonomy on medication errors, and a growing network for health care professionals.

In our systematic review on IT interventions we found out that involvement of pharmacists and collaboration between all health care providers and patients is a promising approach to improve medication safety in primary care. Moreover, IT interventions alone did improve medication safety significantly only in 50% of the included randomized controlled trials and some of the IT interventions even produced problems themselves, like false positive alerts or system errors. Nevertheless it depicted a realistic view on the current state of the art regarding the effect of IT interventions to improve medication safety in primary care and reminds us to be cautious about implementing IT-interventions on a large scale without further rigorous evaluation.   

Tools and Guidance notes

Preliminary classification on medication errors in primary care

  • This will be a tool for medication safety improvement It investigates the practicality of a classification scheme for severity ratings, causes and problem types of medication incidents that could occur in primary care settings. Organisations and GPs or Pharmacists can use the tool after a medication incident or check in general which and where common medication errors happen in their own office.

  • SaMSaF

    SaMSaF is a tool for measuring the organisational culture with regard to medication safety in primary care settings, such as GPs' surgeries/practices.  The tool helps users assess the current level of maturity of their approach to medication safety, and use the output as a basis for discussions on how to improve factors contributing to medication safety.  Testing of this new tool is in progress.  See WP2 (German - Fratrix) and WP5 (UK - MaPSaF).

Journal papers

  • Tache S, Soennichsen A, Ashcroft D. Prevalence of Adverse Drug Events in Ambulatory Care: A Systematic Review. Ann Pharmacolther 2011; 45(7-8): 977-989 (published; abstract).
  • Information technology interventions to improve medication safety in primary care: a systematic review.  Miriam Lainer; Eva Mann; Andreas Sonnichsen.  International Journal for Quality in Health Care 2013; doi: 10.1093/intqhc/mzt043

Conference proceedings

  • A. Soennichsen, Medication Safety in Primary Care, Medication Safety conference, Vienna, Austria/2009 (presented; abstract)
  • A Soennichsen, The Epidemiology of Medication Error in Primary Care, Manchester, UK/2010 (presented; abstract)
  • M Lainer, What can we do about Medication Errors in Primary Care?,  Manchester, UK/2010 (presented; abstract)
  • A Soennichsen, Patientenverwechslung beim Hausarzt – (k)ein-) Problem, ANETPAS, Linz, Austria/2011. (presented; abstract)
  • A Soennichsen, Patient Safety in Family Medicine, EQUIP, Copenhagen, Denmark/2011. (presented; abstract)
  • A Soennichsen, Lainer M, Medication safety: Interventions for Quality Improvement in Primary Care, WONCA, Warsaw, Poland/2011. (presented; abstract)
  • M Lainer, Führen computerunterstütze (IT) - Interventionen zur Verbesserung der Medikamentensicherheit in der Allgemeinmedizin-Praxis? : eine systematische Übersichtsarbeit von randomisiert kontrollierten Studien, FM 21 Kongress , Salzburg, Austria/2011 (in German) (presented; abstract)
  • M Lainer, A Voegele. Information technology (IT) interventions to improve medication safety in primary care, Lodz, Poland/2012. (presented; abstract)
  • M Lainer, A Voegele, Interventions to improve medication safety in primary care in Europe , WONCA, Vienna, Austria/2012 (presented; abstract)
    A Voegele, M Lainer, Development of a Classification of Medication Safety Incidents in Primary Care, WONCA, Vienna, Austria/2012 (presented; abstract)

LINNEAUS deliverable(s)

  • LINNEAUS Deliverable No. 8: Report on learning processes including an evaluation of the impact of medication errors finished in Month 42 (due Sept 2012).

Other LINNEAUS reports

  • LINNEAUS Milestone No. 3: Data on European studies on medication errors completed – data collated and published. Systematic review on prevalence ADE (see above) Presented in conferences in Manchester and Malaga 2010
  • LINNEAUS Significant Achievement 3.1: Evaluation and presentation of the identified European projects on medication errors including the results of the Austrian pharmacovigilance project review published soon
  • LINNEAUS Significant Achievement 3.3: Presentation of joint proposals, interventions and other solutions for the improvement of error detection and prevention by the European network conferences in Kopenhagen and Warsaw 2011
  • LINNEAUS Significant Achievement 3.4: Evaluation of impact of medication errors and preventive measures on public health and health economics Systematic review on IT interventions (in process to be published)
  • LINNEAUS Significant Achievement 3.5: Report on further dissemination of learning processes regarding the prevention of ADEs and evaluation of health professionals’ education.  Final report due September 2012
  • Potentielle schwere Interaktionen bei Patienten mit Polypharmazie; Ergebnisse einer Pilotstudie: Unterschiedliche Klassifizieren von Interaktionen in verschiedenen Datenbanken" (S. Gundl (2010) German Medical Sciences. DOI: 10.3205/10ebm008, URN: urn: nbn:de:0183-10ebm0086.
    www.egms.de/de/meetings/ebm2010/10ebm112.shtml (abstract; in German)
  • Medikation ohne Evidenzbasis (EB) bei Patienten mit Polypharmazie; Ergebnisse einer Pilotstudie (D. Koper (2010) German Medical Sciences. DOI: 10.3205 /10ebm 112, URN: urn:nbn:de:0183-10ebm1127
    www.egms.de/de/meetings/ebm2010/10ebm112.shtml (abstract; in German).

Links

www.pmu.ac.at 
www.equip.ch
www.plattformpatientensicherheit.at/ (Austrian EUNetPaS)

www.cirsmedical.at